Oral oncology · 2026
Reliability of frozen section in detecting tumor-free margins in oral squamous cell Carcinoma: a systematic review & meta-analysis.
Систематический обзорСтатьяМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Abbas Rezhat, Garg Aarushi, Kumar Priya, Augustine Jeyaseelan, Urs Aadithya B
Аннотация
BACKGROUND: The frozen section technique is a vital intraoperative diagnostic tool that enables rapid microscopic assessment of tissues, providing immediate information to guide surgical decision-making, including evaluation of tumor margins, disease extent, and metastatic involvement. Given the high risk of positive surgical margins in oral squamous cell carcinoma (OSCC), achieving margin-negative resection is critical to minimizing recurrence. This systematic review and meta-analysis evaluates the reliability of frozen section analysis in detecting tumor-free margins in OSCC.
METHODS: A comprehensive literature search was performed across PubMed, Scopus, Embase, and Science Direct, yielding 1082 records. After removing duplicates and screening titles, abstracts, and full texts, 19 studies met the criteria for qualitative synthesis. Of these, 9 studies with complete 2 × 2 data were included in the quantitative meta-analysis.
RESULTS: Under the random-effects model, frozen section demonstrated a pooled sensitivity of 0.78 (95% CI: 0.55-0.91) and a pooled specificity of 0.98 (95% CI: 0.96-0.99). The common-effect estimates were lower due to the influence of larger studies. The SROC curve from the Reitsma bivariate model showed excellent overall diagnostic performance with an AUC of 0.955, confirming strong discriminative ability in distinguishing positive from negative margins.
CONCLUSION: Frozen section demonstrates high specificity and acceptable sensitivity in detecting margin status in OSCC. The strong overall diagnostic performance supports its value as a reliable intraoperative tool. Incorporating frozen section assessment may improve surgical precision and reduce the risk of residual disease.
METHODS: A comprehensive literature search was performed across PubMed, Scopus, Embase, and Science Direct, yielding 1082 records. After removing duplicates and screening titles, abstracts, and full texts, 19 studies met the criteria for qualitative synthesis. Of these, 9 studies with complete 2 × 2 data were included in the quantitative meta-analysis.
RESULTS: Under the random-effects model, frozen section demonstrated a pooled sensitivity of 0.78 (95% CI: 0.55-0.91) and a pooled specificity of 0.98 (95% CI: 0.96-0.99). The common-effect estimates were lower due to the influence of larger studies. The SROC curve from the Reitsma bivariate model showed excellent overall diagnostic performance with an AUC of 0.955, confirming strong discriminative ability in distinguishing positive from negative margins.
CONCLUSION: Frozen section demonstrates high specificity and acceptable sensitivity in detecting margin status in OSCC. The strong overall diagnostic performance supports its value as a reliable intraoperative tool. Incorporating frozen section assessment may improve surgical precision and reduce the risk of residual disease.